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The Role of Renal Denervation in the Treatment of Hypertension

  • Vascular Disease (R Schainfeld, Section Editor)
  • Published:
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Opinion statement

Resistant hypertension remains a difficult clinical disease to treat. It is known to place a patient at higher risk for developing significant cardiovascular, renal, and cerebrovascular disease. There is a current surge in research investigating renal denervation as potential treatment for resistant hypertension, as an overactive renal sympathetic system is known to exert an influence on the underlying pathophysiology. Several small studies have been published, with more underway, evaluating multiple different catheter-based systems that utilize radiofrequency ablation or ultrasound wave energy. These studies are showing promising results, with reduction in office blood pressure for the majority of patients. However, it appears that this does not always translate into definitive real-world observational effects. Variability exists in the number of patients that are able to reduce the amount of medication they take for hypertension, with some requiring an increase in medication. As a result, a more intensive screening process has been proposed, evaluating specific key predictors that may translate into a more favorable clinical response to renal denervation. We recommend that individuals with resistant hypertension continue to be optimized medically, adequately screened for secondary causes of hypertension, and that they consider participation in a renal denervation clinical trial to aid in further advancing the field.

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Conflict of Interest

Dr. Kyle J. Feldmann and Dr. Mitchell J. Silver each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of Internal Medicine, Riverside Methodist Hospital, Columbus, OH, USA

    Kyle J. Feldmann MD

  2. Division of Cardiovascular Medicine, Ohio Health Heart and Vascular Physicians, Riverside Methodist Hospital, 3705 Olentangy River Road, Columbus, OH, 43210, USA

    Mitchell J. Silver DO, FACC, FSVM

Authors
  1. Kyle J. Feldmann MD
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  2. Mitchell J. Silver DO, FACC, FSVM
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Correspondence to Mitchell J. Silver DO, FACC, FSVM.

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This article is part of the Topical Collection on Vascular Disease

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Feldmann, K.J., Silver, M.J. The Role of Renal Denervation in the Treatment of Hypertension. Curr Treat Options Cardio Med 16, 321 (2014). https://doi.org/10.1007/s11936-014-0321-6

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  • DOI: https://doi.org/10.1007/s11936-014-0321-6

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